There are no comprehensive analyses of the racial integration of health care in the United States in the fields of history, political science, health policy, and health administration. Explicit discrimination against minorities, however, still existed in the 1960s in hospital patient admissions and physician and nurse staff appointments. With passage of the Civil Rights Act in 1964, and the Medicare legislation in 1965, civil rights advocates within the federal government had both a legislative mandate to guarantee equal access to programs funded by the federal government in Title VI of the 1964 Civil Rights Act, and a federal program that affected every hospital in the country in Medicare. This study will determine the extent to which the Medicare program was the major determinant in the racial integration of hospitals, and thereby assess the impact of economic incentives used by the federal government and civil rights advocates to achieve and then to secure the racial integration of hospital care set in the broader context of the civil rights movement and national priorities to expand health coverage to older Americans. This project will reveal the central role played by the National Association for the Advancement of Colored People beginning in the 1930s in laying the foundation for the racial integration of health care decades later under Medicare. This was accomplished through establishment of organization policies and programs, use of the courts in establishing legal precedent, building a consensus for integration among African-American health professionals, and then by engaging and pressuring executive leadership individuals to implement federal regulations consistent with legislation and court rulings. Primary sources include archival manuscripts, personal collections, government documents, newspapers and lay and medical journals as well as in-depth oral history interviews with individuals involved in the racial integration of hospitals at the local, regional and national levels. This proposal is to support the publication of a one-volume work that will serve as a comprehensive analysis of the racial integration of health care in the United States, and the preparation of the oral histories for deposit into a national archive.